Latar belakang: Di Jerman, asam lipoid terdaftar dengan indikasi "polineuropati perifer diabeti?'. Laporan kasus ini bermaksud mempertunjukkan aktivitas terapetik yang melebihi indikasi ini. Di Indonesia, substansi ini tidak terdaftar untuk terapi.
Metoda: Tiga pasien (dua di antaranya di Jerman, dan satu di Indonesia) dengan gejala patologi neurologik yang berbeda dari polineuropati diabetik perifer diterapi dengan asam α-lipoat: i) gejala peradangan pasca-boreliosis dengan artritis dan parestesi, ii) gangguan sensorik dan motorik pasca kemoterapi dan pasca operasi karsinoma mammae yang terjadi sejajar dengan terapi radiasi, dan iii) krisis pulmonar dan kardiovaskular pasca-trauma dan pasca bedah otak, dengan gangguan patologi neurologik (sensorik, motorik, visual dan auditorik) serta disartria.
Hasil: Ketiga pasien mengalami perbaikan begitu dimulai dan dilanjutkan pemberian asam lipoat, sementara tindakan terapetik lainnya tampaknya kurang memberi hasil baik. Kemungkinan terjadinya interaksi antara terapi lain dengan asam lipoat, kemungkinan secara sinergistik atau aditif pendukung, tidak dapat disingkirkan; namun, secara terpisah, atau dengan interaksi, tampaknya asam lipoat membantu kesembuhan pada pasien-pasien tersebut dari gejala patologi neurologik, dalam istilah kedokteran tradisional "restitutio ad integrum"
Kesimpulan: Pada ketiga kasus pada penelitian ini, asam lipoat agaknya efektif untuk keadaan patologi neurologik yang berbeda dari neuropati diabetik perifer. Diperlukan studi selanjutnya untuk memastikan efektivitas ini. (Med J Indones 2011; 20:143-8)
AbstractBackground: In Germany, lipoic acid is registered with the indication of "peripheral diabetic polyneuropathy"?. This report intends to demonstrate therapeutic activity beyond this indication. In Indonesia, the substance is not registered for therapy.
Methods: Three patients (two of them in Germany and one in Indonesia) with pathoneurological symptoms different from peripheral diabetic polyneuropathy were treated with α-lipoic acid: i) post-borelliosis infl ammation with arthritic and paraesthetic symptoms, ii) post-operative (mamma carcinoma) and post-chemotherapeutic sensoric and motoric neural defi cits occurring in parallel with additional radiation therapy, and iii) post-traumatic (cerebral) and postoperative (brain surgery) cardiovascular and pulmonary crisis with broad pathoneurological (sensoric and motoric, visual, auditory) defi cits and dysarthria.
Results: All three patients improved in close correlation with the onset and continuation of lipoic acid intake, whereas other therapeutic measures did not appear very successful. It cannot be ruled out that the other therapeutic regimens applied interacted with lipoic acid in a supporting additive or synergistic manner, because three cases as reported here do not allow for such conclusion; however, separately, or with interaction, lipoic acid helped the patients to recover from their pathoneurological symptoms in the meaning of the traditional medical term "restitutio ad integrum".
Conclusion: In the three cases in this study, lipoic acid was effective in therapy of pathoneurological symptoms different from peripheral diabetic neuropathy. Further confi rmative studies are suggeted. (Med J Indones 2011; 20:143-8)
